Provider Demographics
NPI:1356489413
Name:MELNITSKY, LORI M (SLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:M
Last Name:MELNITSKY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3117
Mailing Address - Country:US
Mailing Address - Phone:516-776-0184
Mailing Address - Fax:516-933-0030
Practice Address - Street 1:7 LINDA LN
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3117
Practice Address - Country:US
Practice Address - Phone:516-776-0184
Practice Address - Fax:516-933-0030
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007626-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist